MRSA & VRE
Public Safety Information for Patients and Families

Pembroke Regional Hospital takes your care and your safety very seriously and we are extremely committed to transparency If you have any questions about the information below or about our hospital’s infection prevention and control program, please contact patient_safety@pemreghos.org

• The dedicated health professionals who work in this hospital are committed to providing the best possible care to our patients.
   
• Our hospital strongly supports the provincial government’s new public reporting regime because we believe it will inspire improved performance, enhance patient safety, and strengthen the public’s confidence in Ontario’s hospitals.
   
• Public reporting of MRSA, VRE and other indicators is another, helpful measure to ensure the care provided to our patients is even safer, and improves over time.
   
• Public reporting of our hospital’s MRSA and VRE rates will allow us to establish a baseline from which we can then track our rates over time. If we feel our rates have risen above our baseline, we can look internally at our hospital’s processes, identify areas for improvement, and implement strategies to reduce the incidence of these infections in our organization.
   
• Patients should know that their hospital is safe, that the care you receive here is top-notch, and that every effort is being made to ensure you receive safe, high-quality care.
   
• The public reporting of MRSA and/or VRE rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. Some hospitals may experience higher rates of bacteraemia due to their type (i.e. acute care) and patient population (i.e. elderly).
   
• A high number of MRSA or VRE bacteraemia in a one-month period does not necessarily mean that a hospital is “unsafe;” a lower number of cases in a one-month period does not necessarily mean that a hospital is “safe.” That is why it is vital that the rates are viewed in the context of other performance indicators.
   
• That said, the analysis of our MRSA and VRE rates over time will certainly provide us with helpful information that we can use to make quality improvements in our organization.
   
• We look forward to working with our health professionals to make those improvements in the time ahead.

 
The following patients are at increased risk for both MRSA and VRE and should be screened for MRSA and VRE:

1. those who have previously been colonized or infected with MRSA or VRE
2. those who have spent time in a health care facility outside of Canada in the last 12 months;
3. those who have been admitted to, or who have spent more than 12 continuous hours as a client/patient/resident in, any health care facility in the past 12 months;
4. those transferred between health care facilities (e.g. between hospitals or between a long-term care facility and a hospital);
5. clients/patients/residents who have recently been exposed to a unit/area of a health care facility with an MRSA or VRE outbreak;
6. other high-risk client/patient/resident populations as identified by the Infection Prevention and Control Professional(s), Public Health or the Regional Infection Control Network.
    

Hospitals should employ Contact Precautions for patients with MRSA and VRE, these include:

• Hand hygiene as described in Routine Practices (refer to Appendix D, “PIDAC’S Hand Hygiene Fact Sheet for Health Care Settings”);
• Appropriate patient placement, i.e. single room or cohorting of patients.
• Gloves for entering the patient’s room or bed space;
• Long-sleeved gown for entering the patient’s room or bed space;
• Hand hygiene by the patient before leaving his/her room;
• Dedicated use of equipment or adequate cleaning and disinfecting of shared equipment.
   

What are hospitals doing to improve the occurrences of hospital-acquired infections?

There is strong collaboration among Ontario hospitals, the provincial government and the Ontario Hospital Association to continually improve system performance, particularly in the area of patient safety.

Measuring Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) rates.

Pembroke Regional Hospital posts its infection rates online on a quarterly basis. On this website, you can find information about hospital-acquired infection rates for MRSA and VRE.

Is it likely or possible that infection rates for MRSA and VRE will vary from hospital to hospital?

Yes, rates may vary and may be a factor of the types of procedures and services or depending upon the type of patients served by the hospital.   

What are the screening recommendations for hospitals?

Screening is conducted to identify colonized and infected patients. Screening is not a control method in itself and Routine Practices must be carried out on all patients at all times whether or not screening is conducted. Screening for risk factors for MRSA and VRE should include a screening tool that is applied to all patients admitted to the hospital.

Is decolonization of infected patients recommended?  

Decolonization refers to the use of topical agents, such as nasal antimicrobial ointment and body wash and/or oral antibiotics, to remove resistant bacteria from a colonized individual. Decolonization has been used, along with other measures, to help control the spread of MRSA and VRE in some centres.

According to the best practices document, decolonization therapy of MRSA and VRE patients is not currently recommended.